Provider Demographics
NPI:1033691548
Name:GROOM, VERONICA LYNN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:LYNN
Last Name:GROOM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WINSLOW RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2262
Mailing Address - Country:US
Mailing Address - Phone:586-419-8501
Mailing Address - Fax:
Practice Address - Street 1:19 WINSLOW RD UNIT 1
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2262
Practice Address - Country:US
Practice Address - Phone:586-419-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119853104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker